Clinicians, Public Benefit From Cultural-Diversity Programs

Community mental health programs and academic centers are chipping away at the problem of mental health disparities among racial and ethnic minorities with education, advocacy, and anti-stigma initiatives.

A number of mental health advocates and clinicians associated with these initiatives met in Philadelphia for APA's Office of Minority and National Affairs (OMNA) on Tour meeting in Philadelphia in March to discuss what they have accomplished.

OMNA on Tour is designed to generate discussion about racial and ethnic disparities in mental health care and spotlight model programs that aim to reduce disparities and help minorities find relief from mental health problems (see related article at left).

Medical students and residents at the Robert Wood Johnson Medical School-Camden in Camden, N.J., are trained about cultural issues from“ day one,” according to Thomas Newmark, M.D., chief of the department of psychiatry at the Cooper University Hospital and professor of psychiatry at the Robert Wood Johnson Medical School.

Camden's population is 53 percent African American, 27 percent Latino, and 3 percent Asian, according to Newmark, so “our medical students and residents need to learn about the culture of the patients they are treating.”

Medical student orientation includes sessions on the importance of understanding race, ethnicity, and culture from the health care delivery standpoint, he noted.

Medical students also take simulated clinical exams that teach cultural competency and participate in “Harmony Day,” in which“ culture is celebrated, and students from different ethnic backgrounds display through dress, dance, music, and food their unique cultural backgrounds,” Newmark said.

In a Philadelphia-area program, psychiatrists, health care administrators, and consumer mental health staff received diversity training under a program called Partners Reaching to Improve Multicultural Effectiveness Institute (PRIME). The Substance Abuse and Mental Health Services Administration funded the training, which was led by staff and faculty from Drexel University College of Medicine, Behavioral Healthcare Education, and the University of Pennsylvania School of Social Work's Mental Health Research Center. The training ended in January.

According to Cheri Avery-Black, M.A., the program's director, PRIME sought to increase awareness of cultural issues in trainees and to help them“ learn about the impact of discrimination on help-seeking behaviors and the expression of psychiatric symptoms.”

Trainees also learned how to integrate culture into group, family, and social network interventions that supported recovery, she said.

In addition, trainees participated in a two-day session outlining strategies that prevent people from internalizing messages of discrimination, which can worsen mental health problems.

There were also a number of demonstration projects under PRIME, including one in which minority students participated in a school-based program that used creative arts to help them manage stress arising from cross-cultural conflicts.

“Negative cross-cultural encounters in school exacerbated emotional and behavioral problems” in the children, Avery-Black noted.

Through theatrical performances, poetry, drawing, and music, the students expressed and resolved these conflicts with the help of program staff, she said.

Another program featured at the OMNA on Tour meeting seeks to teach minority residents of Wilmington, Del., that mental illness is common and treatable.

Paul Galonsky, senior community educator of the Mental Health Association in Wilmington, began by presenting mental health information at local churches and community centers. He also established a mental health support group for the community's minority members, which meets regularly at a Wilmington church.

By partnering with the local branch of the National Association for the Advancement of Colored People, area churches, a Latin-American community center, and state and city officials, Galonsky helped to establish the first Annual People of Color Mental Health Conference in Delaware in October 2002.

The first meeting attracted more than 200 attendees and has grown each year since. This year's conference will be held on November 4, and its theme is“ Celebrating Five Years of Mental Health Education Through Mind, Body, and Spirit.”

Galonsky said, “We wanted to create the conference for the lay individual,” who may have a number of misconceptions about mental health and mental illness.

He wanted community members to realize that mental health issues impact everyone. “I wanted to create a sense of urgency around this—that the risk of not treating mental illness is everybody's problem,” noted Galonsky.

At each conference, mental health experts and advocates educate the public about risk factors for mental health problems in minorities, for instance, and where they can find mental health services in the community.

Some of the sponsors of the annual conference include APA's OMNA on Tour program, a number of pharmaceutical companies, and the U.S. Surgeon General's Office. ▪